Evaluation of Pain and Opioid Use in Ptosis and Blepharoplasty Surgery

The purpose of this study was to quantify the postoperative pain experience of patients undergoing ptosis repair and/or blepharoplasty and to determine the actual number of opioid pills used by patients with the goal of reducing postoperative opioid prescriptions.

In Part I of the study, 40 consecutive patients undergoing eyelid surgery were asked to rate their pain levels at specified time points following surgery. In Part II of the study, each patient between November 2017 and January 2020 undergoing eyelid surgery was prescribed six narcotic pills. They were contacted at 2 weeks postsurgery and asked how many narcotic pills they actually used and whether they had used other non-narcotic analgesic methods.

In Part I of the study, pain levels were higher in men and peaked at 6 h after surgery with an average rating of 3.8 and steadily decreased to an average of 1.1 at 7 days postprocedure. In Part II of the study, 286 patients (108 male and 178 female) were included. The mean number of narcotic pills used was 4.1, with male patients using slightly more pills than female (4.00 vs. 5.00, p < 0.001). 205 of 286 participants (72%) used a non-narcotic analgesic, and 49 of 286 participants (17%) indicated use of marijuana.

Blepharoplasty and ptosis repair have low levels of postoperative pain. Further, this study demonstrates that six opioid pills is a reasonable prescribing guideline and that opioid prescriptions can be safely reduced without compromising patient comfort and pain.